Provider Demographics
NPI:1629754320
Name:WALK IN FAITH, PLLC
Entity Type:Organization
Organization Name:WALK IN FAITH, PLLC
Other - Org Name:CABOT HEALTH & WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PEDIATRIC NURSE PRACTITIONER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MACCONAUGHA
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, CPNP-PC
Authorized Official - Phone:501-422-6700
Mailing Address - Street 1:906 S PINE ST STE 5
Mailing Address - Street 2:
Mailing Address - City:CABOT
Mailing Address - State:AR
Mailing Address - Zip Code:72023-3837
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:906 S PINE ST STE 5
Practice Address - Street 2:
Practice Address - City:CABOT
Practice Address - State:AR
Practice Address - Zip Code:72023-3837
Practice Address - Country:US
Practice Address - Phone:501-422-6700
Practice Address - Fax:501-422-6710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-26
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty